Organization
PRODIGY MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D HALPIN (CEO)
(907) 226-3400
Entity
Organization
Contact information
Practice address
3000 A ST STE 405, ANCHORAGE, AK 99503-4040
(907) 444-8876
(907) 782-4208
Mailing address
4107 HOHE ST, HOMER, AK 99603-7008
(907) 226-3400
(907) 226-3300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
991850
STATE OF ALASKA
AK
Enumeration date
10/18/2018
Last updated
01/14/2026
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